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Dartmouth-Hitchcock COVID-19 Relief Suites

Updated: Apr 19, 2023

Manchester and Nashua, New Hampshire

Dartmouth-Hitchcock, Manchester (Panoramic Photo: Matthew Fitzemeyer)

Fitzemeyer & Tocci (F&T), along with Johnson Controls International (JCI), balancing contractors H&S Associates, Granite State Plumbing & Heating and the Dartmouth-Hitchcock team are nearing completion for the conversion of two urgent care suites into COVID-19 relief suites. As soon as news of the virus begin to spread about the country, F&T began the discussion with Dartmouth-Hitchcock to convert their existing Urgent Care suites at both the Manchester and Nashua locations into negative pressure areas.

Dartmouth-Hitchock, Nashua (Photo: Matthew Fitzemeyer)

After quickly onboarding the team, all parties were up to the challenge of supporting Dartmouth- Hitchcock in their effort to fight COVID-19, knowing the effort is a time sensitive matter. Using existing drawings and as-builts, F&T rapidly prepared conceptual design plans and narratives before even stepping foot on site. Following the project kickoff, with the schedule of doctors, nurses and cleaning crews in mind, early morning and late-night work began. Starting in Manchester, the first challenge was containing the air in the space as it was an existing plenum return system. F&T provided an engineering solution to add a ducted return system off the existing main serving all examination rooms in the space, to ensure the rooms will be consistently negative. Once plans were in place, Granite State installed the ductwork over the course of three nights. After the new return ductwork was installed in Manchester, the strategy in both facilities was the same. JCI re-programmed the rooftop units (RTUs) serving the space to 100% outdoor air making the return system a temporary exhaust system to ensure the “dirty”, contaminated air is discharged out of the building entirely. In conjunction with the RTU change, JCI modified terminal unit setpoints, both within and outside the perimeter of the urgent care suite, as required to maintain an overall negative suite pressure to help contain the spread of the virus during this pandemic. Exam and procedure rooms within the suite where either confirmed or suspected Covid-19 patients will be treated were rebalanced to be negative pressure so contaminants will not spread out of the rooms and into corridors or staff work areas; and in a subset of exam rooms where aerosol generating procedures could be performed the negative pressure balancing target was like that of an isolation room . Additionally, corridors, support areas and staff working areas were rebalanced to be positive pressure to prevent contaminants from entering or sitting stagnant in these spaces. Once each room was carefully rebalanced to ensure the air within the suite was flowing in the right direction, differential pressures were taken across each door in the suite and each door or seal at the perimeter of the suite. Completing this process at both locations, all exam rooms were negatively pressurized and the suite in its entirety was negative to the rest of the building as intended. Dartmouth-Hitchcock now has two suites that can treat presumptive positive or confirmed positive COVID-19 patients while limiting exposure to the rest of the medical center. The exceptional teamwork from all members was imperative to the success of the project. Throughout the entirety of the project, all parties communicated daily; sharing knowledge and experience, reporting findings on site, scheduling the next field visits, and collaborating on plan of attack all while keeping the client’s schedule and needs in mind.


Written by:

Matthew Fitzemeyer

Project Manager &

Mechanical Design Engineer


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